Individual provider Active NPI

Matthew Sharp, D.O.

  • Child & Adolescent Psychiatry Physician
  • Tulsa, OK
National Provider Identifier
1790224293
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
6492 Issued in OK
Practice address
3417 E 39TH St
Tulsa, OK 74135-4633
Phone
(405) 201-3692
NPI assigned
Feb 16, 2017
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X 6492 OK Primary

Addresses

Primary practice location

3417 E 39TH St
Tulsa, OK 74135-4633

Mailing address

1620 E 12TH St
Tulsa, OK 74120-5407
Phone (918) 588-8807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230815001242 OK Practitioner - Psychiatry 8729464425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkside, Inc.Group PAC ID 5496644049, 15 clinicians

Practice addresses (Care Compare)

1239 S Trenton Ave
Parkside Psychiatric Hospital and Clinic
Tulsa, OK 74120-5420
Phone (918) 588-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6492OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Parkside, Inc. Single Specialty CurrentSince Jun 18, 2023 Accepting new patients
Parkside, Inc. Single Specialty Current Accepting new patients
Parkside, Inc. Single Specialty CurrentSince Jun 18, 2023 Accepting new patients
Parkside, Inc. Single Specialty Past Accepting new patients
Parkside, Inc. Past Accepting new patients
Parkside, Inc. Single Specialty Past Accepting new patients
Acadia Healthcare, Inc Single Specialty Past Accepting new patients

Locations

1239 S Trenton Ave
Tulsa, OK 74120
Phone (918) 582-2131

1620 E 12th St
Tulsa, OK 74120
Phone (918) 582-2131

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1790224293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205407",
            "telephone_number": "918-588-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 E 39TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741354633",
            "telephone_number": "405-201-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-16",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OK",
            "license": "6492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.